Twenty-three (23) of the 25 respondents indicated their basic funding needs (in dollars), for allied health training during the next fiscal year: The results in these two tables demonstrate very clearly that the greatest need is for construction: 66 percent of the total needs were specified to be in that Furthermore, the 23 respondents indicated that about 71 percent of the category. total ($20.5 million) would be needed from federal funds. However, once again, it must be emphasized that these do not represent the total nationwide needs, but merely the needs of 23 senior colleges and universities. LEGISLATIVE PROPOSALS After considering past experience and present needs, the questionnaire asked the respondents to comment on the relative merits of the various legislative proposals as they saw them. The respondents were asked what effect they felt the administration proposal concerning funds for the fiscal year beginning July 1, 1970, would have on their college/university, and also what effect they felt this would have nationally. Twenty (20) of the 25 respondents indicated that funds were inadequate and they doubted that their college/university would receive adequate funding. They stated that this would inhibit new development, and might possibly lead to reduction of educational programs due to faculty resignations, and to reduced student enrollment. Comments were solicited concerning the Yarborough bill, S. 3586. Eighteen (18) of the 25 respondents supported the proposed funding; three (3) felt that the proposed funding was inadequate; and the remaining 4 institutions did not respond. A large majority of the respondents (20 of 25) expressed support for the idea of separate funds for Basic Improvement Grants and for Special Project Grants. In response to the proposed change from "training centers for allied health professions," to "public and non-profit private agencies, institutions, and organizations," 17 of the 25 reporting institutions expressed concern that (a) standards might be lowered, (b) funds might be further diluted, and (c) the change would not be in the interest of the allied health professions. Four (4) of these seventeen (17) institutions also expressed a desire for further clarification of what is intended by "public and non-profit private agencies, institutions, and organizations." The final inquiry was concerned with administration, management, and control of scholarship grants, work/study programs and student loans as proposed in the Yarborough bill. Sixteen (16) of the 25 respondents reported favorably on the scholarship grants; five (5) made no response to this item. The remaining four (4) respondents expressed a desire for further definition of "exceptional financial needs" and expressed concern over the writing of the regulations implementing the legislation. While 15 of the 25 respondents favored the work/study programs, six (6) of the respondents were concerned with the definitions, the regulations and implementation; and four (4) institutions failed to respond to this item. Seventeen (17) of the 25 respondents were in favor of the provisions for student loans, The CHAIRMAN. I share with you this concern over the virtual abandonment of this program to have only 1 year extension of it. We hope that the crisis in medical treatment in this country might be aleviated by training more allied health professionals. Your paper points out that the ratio has increased from 1900 from one health professional for each physician to 13 to 1 today. The estimate is that by 1975 this ratio should grow to 20 to 25 allied health professionals for one physician. We must grow if we are to get more medical people with the small number of medical doctors and the small number we foresee by 1975. Let me ask you about the experience of your association. What is your experience with reference to 1-year extension? Do you think you could encourage the people to come to teach in these schools if the authorization were for only a 1-year extension? Dr. HAMBURG. I think we would put the majority of our programs in allied health at great risk if there wasn't some assurance on the part of the universities and their boards of directors and trustees that there would be a continuation of support. Many of our universities and colleges are taking very careful looks at some of the things they have termed "soft money." At one time such things as basic improvement grants were considered hard money, guarantees; formula grants were coming in each year. When the basic improvement grant for those provisions under the Allied Health Training Act were reduced in a time of need from 80 percent last year to approximately 65 percent this year, we express grave concern for the future support of these programs. The CHAIRMAN. You say that your information is that you do have adequate numbers of qualified students if the programs were available? Dr. HAMBURG. Yes, sir. Most of the reporting schools and colleges in this questionnaire felt that the availability of qualified students was of secondary importance. The primary concerns were to find adequate facilities in which to train them and qualified people to prepare them. The CHAIRMAN. You have pointed out that in view of the cost increases in educational institutions today, the inability to secure Federal funds, that the number of the member schools have had to actually cut back on their recruitment programs at a time when the articles in the medical journals by health experts and medical experts and scientific experts and the newspapers all show this is the great hope for increasing the medical care for the American people. I think the cutbacks are just shortsighted and inexcusable. I hope we can extend this act beyond this brief 1 year period. Senator Javits? Senator JAVITS. Thank you, Mr. Chairman. Mr. Chairman, I regret other duties have prevented me from being here until now. I ask unanimous consent that the complete text of my prepared statement be put in at the opening of the hearings. The CHAIRMAN. Without objection. Senator JAVITS. I congratulate the Chair for having commenced hearings on allied health profession legislation. I am pleased these hearings include two bills I have sponsored, one with Senator Prouty, S. 2753 and one with Senators Prouty, Murphy, Dominick, and Saxbe, all the minority members of the Health Subcommittee, S. 3718. I would also like to express appreciation to the Chair that the Chair's bill, S. 3586 incorporates the basic features of my own bill S. 2753. And I ask unanimous consent that certain articles from the Journal of the American Medical Association and of the National Academy of Science on allied health personnel be made part of my remarks. The CHAIRMAN. It is so ordered. Senator JAVITS. I have one question of the witness. It has been a historic situation in this committee, Mr. Chairman, that the degree of consideration given to the legislative ideas of the minority has never been discriminated against or prejudiced. Senator Hill carried that out. Senator Yarborough has most effectively and magnificently adhered to that tradition. The CHAIRMAN. We want to congratulate you Senator Javits, for the great ideas that you have advanced and that you have written into practically every bill coming out of this committee in the field of education and health. You have had a very substantial input as part of your expertise and dedication to service to people. I don't think we would have had this great growth of beneficial education and health legislation for the past 121⁄2 years without your knowledge and understanding and your drive to put these laws through. Senator JAVITS. I consider this extremely important, in respect to expanding allied health personnel and would like to ask you, sir, would you feel that the problem of licensure as well as State and local laws, regulations, customs and practices as they surround health personnel will require a very thorough review? I realize practically, they are all on the State level but nonetheless, if we are going to get into this field, we have to deal with roadblocks wherever they may be, and wherever they interfere materially with the realization of the full potential in the development of these fields. Dr. HAMBURG. I would agree with the Senator, that there will be a need for very careful scrutiny and review of the existing health practices acts in the several States at the appropriate time. I don't believe this is crucial at the moment. We are certainly on a collision course, however, in the next 2 or 3 years if we are not able to enlarge and expand some of the existing duties of our present professionals or to introduce new health professions into this team. Senator JAVITS. I agree with you about the timing. It is much more crucial and immediate, that we expand these professions: Hence, the various ideas that we have proposed including the use of medical corpsmen from the armed services, et cetera. However, would you not agree, that it would be very useful if this report could come as early as possible to pinpoint the troubles. Because in our country, happily for us, notwithstanding our present problems, when you pinpoint troubles a good deal is thus already done about them. For if we had a landmark report which identified the problems, we would make major progress and breakthroughs by merely identifying problem areas in licensing, certification, et cetera? Dr. HAMBURG. Yes, sir. Senator JAVITS. I hope very much we will consider this very carefully. I have no feeling who does it, whether it is by a council, committee or Dr. Egeberg himself. But I would appreciate very much. your feeling on that score. Because we in our study have felt very keenly that no matter how hard you struggle, and how many people you train, the question is will they be able, will they be permitted to perform the things for which they are trained or are they going to have to be hospital clods because there is no room for them in the professional capacity for which they are trained? Dr. HAMBURG. I think situations like that are deplorable. The CHAIRMAN. Thank you, Senator Javits. Thank you very much, Dr. Hamburg, your general counsel and executive director of the association. I commend you on forming this association. I think it is needed in this growing importance of allied health professions and in the growing need of them in the country. You have made a substantial contribution here this morning in the hearing. Senator JAVITS. I would like to join the Chairman. If we can encourage you, it is a lot better for us if there is some consolidation among the people with a common interest. Dr. HAMBURG. Those are the kindest words we have heard today. The CHAIRMAN. I think the growth of your organization will give drive to this point Senator Javits has raised about proper recognition of the health professionals. The next witness is Dr. Stuart Hamilton, President, Hartford Hospital, Hartford, Conn., and also Chairman of the Council of Teaching Hospitals, Association of American Medical Colleges. STATEMENT OF DR. STUART HAMILTON, PRESIDENT, HARTFORD HOSPITAL, HARTFORD, CONN., AND CHAIRMAN, COUNCIL OF TEACHING HOSPITALS, ASSOCIATION OF AMERICAN MEDICAL COLLEGES, ACCOMPANIED BY JOHN M. DANIELSON, DIRECTOR, COUNCIL OF TEACHING HOSPITALS Dr. HAMILTON. I am Dr. Stuart Hamilton, Secretary-Treasurer of the Association of American Medical Colleges, Chairman of its Council of Teaching Hospitals and President and Executive Director of Hartford Hospital, Hartford, Conn. With me is Mr. John M. Danielson, the Director of the Council of Teaching Hospitals. The association represents all the Nation's 105 medical schools, 368 of our leading teaching hospitals, and 34 academic societies from both the basic science and clinical disciplines. Because of this broad representation, I believe we can speak effectively for the academic medical center which includes the medical school, the faculty and the teaching hospital. It is a pleasure to appear before you today and present our comments on S. 3586 "the Health Training Improvement Act of 1970" introduced by yourself, Mr. Chairman. While we address ourselves primarily to title II of your bill as it relates to the training of personnel in the allied health professions, the Association of American Medical Colleges expresses its gratitude for your forethought in the |